Organization
CDT GMSP, INC
Active
Organization
CDT GMSP, INC
Active
Other names
Lab CDT Gmsp
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILIA E ZAYAS MD (EXUCUTIVE DIRECTOR)
(787) 780-9196
Entity
Organization
Contact information
Practice address
B7 CALLE SANTA CRUZ, AVE. SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 780-9196
(787) 625-6120
Mailing address
B7 CALLE SANTA CRUZ, AVE. SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 780-9196
(787) 625-6120
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
291U00000X
Clinical Medical Laboratory
1028
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039200
MEDICARE PROVIDER
PR
05
—
037546800
—
PR
01
—
1790750529
NPI
PR
01
—
40D0699278
CLIA NUMBER
PR
Enumeration date
02/23/2006
Last updated
02/06/2026
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